Ketamine-Assisted Psychotherapy for Treating an Index Trauma: The Client Experience

Anonymous 15:57

words. It’s definitely hard to put into words. I think having done some prep work around that did help to understand what was, what I was experiencing or had like, I wish I interviewed my notes so I knew exactly

Dr. Signi Goldman 16:21

you know, because it is super interesting. And I know we’re just talking about it broadly, but I’ll say, as your therapist for the ketamine part of your treatment, what I saw, and I see this with other people too, is that, unlike in sort of ordinary awareness, like the way we’re talking right now. When you were on the ketamine, it’s almost like you had the ability to speak for those parts. So I would say to you, like, What is she thinking or feeling? And you would know right away, or you would like, ask her and then tell me it was almost like you were translating or between me and them, or between you and them, and it was clear that there was almost like a way to think of this as a metaphor. Was like more people in the room, and we were all in a dialog with each other.

Anonymous 17:13

And there was definitely some of it was like actually seeing a child, as opposed to and like having, you know, a direct conversation with with that child. Some of it was a little more amorphous than that, you know, but being able to acknowledge and care for that child, and being able to communicate, ask questions and have answers and also give the child a chance to inquire and ask for comfort or ask for clarity on what, what is happening, what is going on? Why is it? Why is this happening? What are they? What’s making them afraid? What’s making what do they need for comfort, sort of things?

Dr. Signi Goldman 18:14

Yeah, I love that you mentioned an opportunity to, you know, ask questions and get answers. So this is kind of a, an intriguing one. So where were the answers coming from?

Anonymous 18:29

A lot. I mean, sometimes it was just a verbal like, what do you want? I want this sort of thing. But the part often speaking directly, okay, but, but I think more often, or just often, it was a feeling of, you know, being able to directly ask the question and then have the feeling of knowing the answer Yeah, and having that resonate Within as as as opposed to being, as opposed to being direct conversation. But that was, that was where it was helpful to have you as you with me, because you could guide me in that sense of, what does she need? What is going on? Sort of questions like that, where you weren’t, it’s not like you were planting things or anything like that, but helping to interact with these parts. Yeah.

Dr. Signi Goldman 19:31

So my word for that, which I think you’ve described in a really lovely way, is sort of prompting you to keep checking in with these parts of yourself and see what’s already there, and spend a little bit more time noticing or checking or listening. And you said something a minute ago that I wanted to highlight. You know, one of the reasons I asked the question like, where, where were these answers coming from, is because I want to make sure to just to. Spell the perception that people may have, that the answers come from me as the therapist about and I but I want to, I want, I kind of partly want, to educate people to by sharing with you and them that like and when I’m doing this kind of work, like with with you, I didn’t know what the answers were going to be either, because I can’t know, because I’m not you. So there the answers are coming from you. And that’s what I think is so fascinating about this kind of work, or one of the many things, because all these parts of us are us, yeah, and so it’s interesting as a therapist to do this work, in a way, because you’re almost watching the client, which was you, in this case, dialoguing with themselves, and almost problem solving and finding out what the needs of the different parts of their own system are, and then providing those needs for themselves in their system, right in this and so it’s I find it very compelling and to watch someone have that, what I what looks like, almost like an empowering experience of that, the the solution comes up kind of organically from the person so and I never know what the solution will be, because I have to wait and hear it from, from you. So that’s so fascinating, right? I just like to put that out there. And there is a concept in this work called non directive approach for the therapist. That means that me, I’m not supposed to feed you anything like, like you said, or, you know, tell you what’s going on. I’m supposed to just prompt you to keep noticing more. But at the same time, there is that prompting that you named, and I think in your sessions, the main two things I was doing over and over again were the mirroring, like you said, which is mirroring your own words back, and then this prompting, which is usually statements like notice, like, see what else is there, or check, what else you can notice and just and then you would do that. You would check

Anonymous 22:06

was a theme, yeah,

Dr. Signi Goldman 22:09

other things that you that feel important to you to say, or that you just think were interesting, or things that were that you struggled with, with it, anything like that that we should talk about.

Anonymous 22:22

Well, I did have the one session that I struggled because with my trauma being medical based, I had a session where I was more aware of the IV being monitored. It like really zoomed in on being in a hospital, having things done to me, like being in that medical scenario. So that was that was like triggering within it, and being triggered while in the ketamine state was much more intense and harder to it was, it was, I was definitely supported, you know, and it was, it was, it was a safe environment. I did not feel safe in that time.

Dr. Signi Goldman 23:17

Yeah, so just to re reiterate that because your trauma was met, was medical trauma when you were hospitalized and hooked up to IVs and such in this session, having the IV in your arm and being manipulated like the IV itself triggered a trauma flashback to that. You know that trauma moment in the hospital, or a kind of a layered series of moments, and you re experience that in the moment, yeah, and I

Anonymous 23:51

afterwards, it was like, I really should have, I felt like I should have anticipated that because of the medic, medical side of getting ketamine treatments is you do have an IV, you are being monitored. I don’t

Dr. Signi Goldman 24:04

think you should have had to anticipate that, just to be fair anyway,

Anonymous 24:09

I feel like I should have been like, oh, this might be a thing.

Dr. Signi Goldman 24:14

Maybe, maybe we should have but so tell what, what. Then, what was your experience of that and how that played out, it was

Anonymous 24:26

very helpful to have you there, to kind of guide me through what we were noticing, but also to kind of help guide me through it and guide me out of it. I did it did resonate in a way that I was impacted,

Dr. Signi Goldman 24:44

like shaken up, you mean, or by impact, the

Anonymous 24:47

heat just turned on. Can you still hear me joining okay, but it did resonate with me for the next day or two. That definitely and had, and it was having that hangover from having, like a very intense experience, that just by having it happen in the supported environment, I was able to move through it at the time, but then it kind of came up and kind of rolled through for the next couple days, where it was like, and then there was this okay, and then there was this, then it was okay. So that that was harder for me, and I do think, you know, we did kind of talk through it, and you know, in about what, what was needed to be supported, what needed to be cared for with this. And it was, it was hard that that one particular session was hard for me, but it didn’t deter me from continuing the treatment. For example, I just was more aware of that and that that was like our second or third session, and so I was still very on board to continue, but in the future sessions, it did. We’ve revisited those places, but had felt reinforced going into it, was able to inter interact with the parts that were triggered or scared or that were traumatized by what had happened and stuff, was able to interact with them and care for them in such a way that we could then move through that time again without the without being triggered as much, without without being overwhelmed, to be able to be more along the lines of, it’s okay, this is happening. We are being cared for, both in the historical that was being revisited, but also we are, we are safe in this environment. We are being cared for in this environment. And this is again, being able to say, you know this, this is not happening again. And also that when, even while this was happening. We were being cared for. We we did have a team helping us at the time. And that was, I remember that, yeah, that was, that was really powerful, yeah, just just being in that space where it felt much safer where I could, you know, explain to the younger selves what was going on, to be able to tell like the young one, no, it’s a we are okay. We were in the hospital. We are being taken care of. We we are okay. You know, you can come into the room, you can look around and ask questions and know that this is this is safe, and you kind

Dr. Signi Goldman 28:08

of that almost like a dialog between the parts this very

Anonymous 28:12

much, yeah, but that was one of the occasions With with Academy, where it’s very concrete. This was my younger part who was humanized, who was a physical person to talk to, to to talk with, and to talk down. And

Dr. Signi Goldman 28:32

that’s super interesting to hear, just from your perspective. That’s what I witnessed as well. But it’s totally different from the outside than you know, I’m sure what you experienced from the inside. There’s a couple things that that I’m curious. One, it’s just a comment, which is, it’s a good reminder that not all ketamine experiences are pleasant, or that ketamine, you can go to some scary places. In that instance, we’ve not return, we triggered a trauma with the IV, and then that became one of the things that we worked with. And that became a thing that was sort of an avenue into working with the whole trauma, in a way, right, one of the avenues into it, but one of the things that I’m curious about is when a part is able to reassure a younger part, or nurture a younger part, or whatever, whatever is called for. I see what from the outside, what looks like a felt like a shift in the person’s body, almost like a shift in anxiety level, like that. I to me, it looks like someone goes from a kind of a tension or looking anxious to almost like a like there seems to be some sort of shift. And I’m curious, and it’s totally fine if you don’t have words for that in or even remember anything like that, because sometimes I’m what I’m seeing from the outside may be different from what you’re experiencing. But do you have any

Anonymous 29:57

thoughts on that? I’m sure. There was definitely the experience of being able to just exhale, and with that, like sinking deeper, or sinking like, I felt like it was hard to, I mean, symbolically, it was, it was it was hard to take a full breath. But during the ketamine treatments, at different points, was able to just exhale and kind of seek deeper into the ketamine experience, but also sink deeper into the feelings, specifically the feelings of being safe or the feelings of being there’s definitely feelings curious there, but being being able to settle more into the experience, and having that release of tension physically, it did feel like exhaling and melting into this, this other world, Ave,

Dr. Signi Goldman 30:57

yeah, maybe a more relaxed place, because there was more sense of safety.

Anonymous 31:02

Yes, definitely, definitely,

Dr. Signi Goldman 31:06

yeah, I think that so much of your work was in your journey with this work was about learning to feel safe or learning to communicate to the different parts that needed to be helped to feel safe. Yes, and I know both of us got a little choked up at times. It’s pretty emotional to watch that bowl for someone, and it’s also very humbling. And I always feel honored just to witness those sorts of journeys, you know, for someone, because it’s, you know, I say this to everyone I interview, because it’s always true like it this is intense and hard work to do. Oh yeah, and it’s and ketamine assisted psychotherapy, or any any kind of psychedelic assisted psychotherapy, is not a situation where the client comes in and is given a psychedelic and is like, Oh, I’m all better now. No, it’s, it’s means that it opens up a doorway to some really hard work that the client then has to sort of step into you in this example. And so just honoring that side of it, because it’s, it can be really powerful change work, and also it’s it’s work, and you have to go through a lot of discomfort sometimes too. So I’m just acknowledging that I witnessed you doing all of that. Also, anything, any advice you would give if you had a friend or someone asked you who wanted to do this, things people should know or think about ahead of time, and if you don’t, that’s okay. But I’m always

Anonymous 32:43

think one of the things that really benefit me was going into it very open to not saying to be uninformed, but going into it and not having the expectations of this is exactly what’s going to happen. That the idea of this journey and things are, because it’s not I’m assuming having only have my own experience, but I’m assuming not everybody has the same experience with it, but also having, definitely having a partnership with your therapist for there, and having an understanding and ongoing dialog Like I personally wouldn’t immediately sit down for the first time with someone I didn’t know. I felt that that was important, that we had a rapport, that there was trust there, that we were very fortunate to have a history working together, which I know we should

Dr. Signi Goldman 33:39

say, though I had never been your therapist before. I’ve been your prescriber

Anonymous 33:42

for years. So with each other, yes, so there, I think

Dr. Signi Goldman 33:51

I like what you’re saying, because it is important that there is a pre existing trust, because that’s what helps create the safety. Because these experiences can be very unnerving and very vulnerable. And there’s a concept in the biz, so to speak, called set and setting that we that the providers talk about, which is the mindset that you’re in, but also the actual like setting, the people you’re with and the environment you’re in, and how that can have an impact for good, but also for ill. If you, for example, don’t feel quite safe with the person, it can really affect the experience. I do think

Anonymous 34:31

that’s the vulnerability there is big. So having that level of trust is really important. And then also in terms of the physical setting, you guys worked very hard to make sure it was very comfortable, very, very, very cared for from the moment coming in, the medical staff was wonderful. The economy. Accommodations in terms of the blanket or the eye mask or stuff, it was punch, it was so fancy. It was like a spa. There was, like the relaxing music playing, and it was, it was like, you know, minimizing external senses so that could really embrace and focus on the internal experience. Yeah,

Dr. Signi Goldman 35:26

yeah, that’s the set and setting pieces. So I’m glad you shared it, because I think it is helpful when people are picking a clinic or picking a place to go to, just think about how the environment will affect them or their relationship with the provider, and just know that all of those, I’m sort of saying this for the audience, but knowing that all those things are important so that because, like you just said it, and I said, it’s vulnerable work, and it takes courage to do it.

Anonymous 35:54

I’m very glad that I went through the experience and it was made such a huge difference coming through the sessions, doing the work, I have had much, much fewer incidences of panic attacks or flooding or being triggered. You know, still, it’s not like 100% cure or anything like that. I’m still continuing to do the work, but it really I feel dealt with the physiology of the trauma to or quicker, more efficiently than some other forms of talk therapy might take longer to get to those spaces. And I had a very positive experience. And I make a point when I’m talking about it’s like I had this experience. This is how it was set up. This is who my provider was. You may not have the same experience, depending on where you go, how things are set up, or how you do it. You

Dr. Signi Goldman 36:50

said that earlier that everyone’s experience is unique in your opinion, on your I think you’re right about that, and I also I thought what you said about not having expectations was perfect advice, because we often say that to people ourselves, like anything it could go any direction, anything can happen. Everybody’s different. Every session can be different. And it’s important not to go in with some idea that this is how it’s going to play out, because it can create some frustration when that’s not what’s happening, and it also can stop you from noticing what might be happening. So considering that you’re relatively new to this world, that was some pretty good professional advice there. I just want to say that it takes some courage to do what you did. You called it a journey, but it’s a hard journey to do, to walk through one’s trauma. So in my opinion, you should be, you get the bulk of the credit for that, because you have to show up for that. So just putting that out there, I think that’s easy for me, to be sitting there witnessing it. You have to show up and feel it right, naming that. So it’s maybe, maybe just

Anonymous 38:04

this is I’m really glad that I did it. Yeah.

Dr. Signi Goldman 38:09

Um, well, I want to thank you for doing this. I appreciate those of you guys who are coming on and doing these interviews. It’s a huge gift to just kind of spread the word and help other people feel comfortable doing it just and also not comfortable, but also fully informed, like knowing that it’s like we said. It’s not necessarily like sprinkle fairy dust and everything’s fixed. It’s challenging work, so it’s helpful to spread that out there and just get more accurate information and hear it from kind of a first hand account. So I really appreciate, I mean, you guys don’t get compensated for this, and you give up your time and your energy to do this. And so I just want to thank you, on behalf of me and everybody else that may sure

Anonymous 38:55

what they said, You’re welcome good.

Dr. Signi Goldman 39:00

So thank you very much again for doing this. 

Outro 39:05

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